Healthcare Provider Details

I. General information

NPI: 1386000925
Provider Name (Legal Business Name): CHRISTINA BRANSCOMB DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12170 CORTEZ BLVD
SPRING HILL FL
34613-5578
US

IV. Provider business mailing address

12362 HOOKER RD
WEEKI WACHEE FL
34614-2833
US

V. Phone/Fax

Practice location:
  • Phone: 352-597-5100
  • Fax:
Mailing address:
  • Phone: 352-238-6974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number29567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: